There are many situations for personal account refund of medical insurance, as follows:
If the insured refuses to deduct the premium from the medical insurance personal account within 10 days and asks for a refund, he can apply for a refund in the following three ways: First, call 955 19 to apply for a refund, the customer service will verify the identity of the insured and make a good registration, and the deducted premium will be returned to the financial account of the insured's social security (citizen) card within 5 working days; Second, the insured person brings valid identity documents to the supplementary medical insurance "Love Without Borders" service window to apply for a refund; 3. Pay attention to the service number of China Life Insurance Co., Ltd. Zhuhai Branch through WeChat, log in to the "Love Without Borders" platform, and complete the "refund application" operation.
Repeated surrender. After the payer completes the payment during the centralized insurance period and enters the treatment enjoyment period, he has participated in residents' medical insurance and employees' medical insurance in other co-ordination areas, and did not enjoy the annual medical insurance benefits. He can apply for a refund at the convenience center of the township (street) with the insured's payment voucher and bank card information.
Death refund. After the payer completes the payment during the centralized insurance period, but dies before entering the treatment enjoyment period, his family members can apply for a refund declaration at the township (street) convenience center with the copy of the insured's death certificate or cremation certificate, the copy of ID card and household registration book, the certificate of heir or immediate family member, the payment voucher and the bank account information of the refund.
Please note that the specific refund process may be adjusted according to actual conditions or policies. If in doubt, please consult the medical insurance bureau. The above contents are for reference only, and you need to communicate with the medical insurance institution for specific operation details.
I. Relevant Provisions on Refund of Personal Account of Medical Insurance
According to the relevant regulations, the refund of personal accounts of medical insurance mainly involves the following situations:
Insured persons who leave the overall planning area and cancel their household registration may apply for returning the balance of their personal accounts.
If the insured person dies for some reason, the balance of his personal account can be inherited according to law.
Insured persons who settle abroad may apply for returning the balance of their personal accounts.
If the insured participates in the insurance repeatedly, he may apply for returning the duplicate part of his personal account.
If the insured person is interrupted for more than three months in a medical year, he may apply for returning the balance of funds in his personal account.
Second, the medical insurance personal account refund process
According to the regulations, the refund of medical insurance personal account needs to be carried out in accordance with the following procedures:
Applicants need to apply to their units or neighborhood committees and submit relevant supporting materials.
With the consent of the unit or the neighborhood Committee, it shall be submitted to the local medical insurance agency.
The medical insurance agency shall review the application materials and verify the refund amount.
After approval, the refund amount will be transferred to the bank account designated by the applicant.
Three, medical insurance personal account refund problems and suggestions
Although the provisions on the refund of medical insurance personal accounts have been clarified, there are still some problems in actual operation:
The refund process is cumbersome: because the refund of medical insurance personal account needs to go through many links such as examination and approval, the whole process is relatively cumbersome and takes a long time.
Unreasonable refund amount: in some cases, there may be a big gap between the refund amount approved by the medical insurance agency and the actual premium paid by the insured, which leads to unreasonable refund amount.
Repeated enrollment: Because the medical insurance personal account is managed according to the ID number, it is easy to have repeated enrollment. This not only increases the financial burden of the insured, but also brings management trouble to the medical insurance agency.
In view of the above problems, the following suggestions are put forward:
Optimize the refund process: medical insurance agencies can strengthen information construction, realize online application and audit, simplify the process and improve efficiency.
Improve the verification mechanism of refund amount: the medical insurance agency can formulate more scientific and reasonable verification standards for refund amount to ensure that the insured can get a reasonable refund.
Strengthen the management of repeated enrollment: medical insurance agencies can establish a more perfect enrollment information management system, find and deal with the problem of repeated enrollment in time, and avoid unnecessary economic losses to the insured.
Four. conclusion
To sum up, the refund of medical insurance personal account is an important part of medical insurance management. In order to better protect the rights and interests of the insured, it is necessary to further improve relevant regulations and procedures, and improve management efficiency and service quality. At the same time, we should strengthen publicity and education, improve the public's knowledge and understanding of medical insurance, and promote the development of medical insurance. Legal basis: Article 23 of the Social Insurance Law.
Employees should participate in the basic medical insurance for employees, and employers and employees should pay the basic medical insurance premiums in accordance with state regulations.
Individual industrial and commercial households without employees, part-time employees who have not participated in the basic medical insurance for employees and other flexible employees can participate in the basic medical insurance for employees, and individuals pay the basic medical insurance premium in accordance with state regulations.